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Öğe Clinical and metabolic effects of medroxyprogesterone acetate and ethinyl estradiol plus drospirenone in women with polycystic ovary syndrome(WILEY, 2008) Ozdemir, Suna; Gorkemli, Huseyin; Gezginc, Kazim; Ozdemir, Mustafa; Kiyici, AyselObjectives: To investigate the effects of treatment with medroxyprogesterone acetate (MPA), 10 days per month for 6 months, on lipid and carbohydrate metabolism in women with polycystic ovary syndrome (PCOS). Methods: Sixty-three women with PCOS were randomized to receive MPA or ethinyl estradiol plus drospirenone. Results: There were no changes in lipid or carbohydrate metabolism in the MPA group, but serum levels of luteinizing hormone (P < 0.001) and total testosterone (P < 0.003) significantly decreased, as did the free androgen index (P < 0.02) and acne (P < 0.03) and seborrhea (P < 0.04) scores. In the ethinyl estradiol plus drospirenone group lipid and hormone values significantly increased whereas acne, seborrhea, hair Loss, and Ferriman-Gallwey scores decreased. There was no statistically significant change in the total cholesterol to high-density cholesterol ratio in either group. Conclusion: Treatment of PCOS patients with MPA provided good menstrual cycle control, beneficial changes in hormonal values associated with hyperandrogenism, and no significant changes in lipid or carbohydrate metabolism. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All, rights reserved.Öğe Clinical correlates of worsening in obsessive-compulsive symptoms during pregnancy(ELSEVIER SCIENCE INC, 2011) Uguz, Faruk; Kaya, Veli; Gezginc, Kazim; Kayhan, Fatih; Cicek, ErdincThis study examined clinical factors related to worsening of obsessive-compulsive disorder (OCD) in pregnant women. For comorbid diagnoses at the onset of pregnancy and frequency of several obsessive-compulsive symptoms, there was a significant difference between women whose OCD worsened during the pregnancy and those in whom the OCD did not worsen. Crown Copyright (C) 2011 Published by Elsevier Inc. All rights reserved.Öğe COMPARISON OF SINGLE VERSUS DOUBLE INTRAUTERINE INSEMINATION(ELSEVIER SINGAPORE PTE LTD, 2008) Gezginc, Kazim; Goerkemli, Hueseyin; Celik, Cetin; Karatayli, Rengin; Cicek, M. Nedim; Colakoglu, M. CengizObjective: To compare the outcomes of single versus double intrauterine insemination. Materials and Methods: This prospective randomized study was carried out in 100 infertile patients. One intrauterine insemination was applied 36 hours after human chorionic gonadotropin (hCG) injection to 50 patients in the first group. To SO patients in the second group, two intrauterine inseminations were applied, of which the first was applied 24 hours after and the second 48 hours after the hCG injection. Results: In the First group, pregnancies were detected in eight patients (pregnancy rate per patient was 16%, pregnancy rate per cycle was 10.6%). In the second group, pregnancies were detected in five patients (pregnancy rate per patient was 10%, pregnancy rate per cycle was 6.4%). There was no statistically significant difference between the two groups (p > 0.05). Conclusion: Single intrauterine insemination can be considered to be more reasonable than double intrauterine insemination treatment, taking into consideration the economic cost and the psychologic trauma to the patients. However, further studies with larger sample sizes are needed in order to reveal any actual differences between the two methods. [Taiwan J Obstet Gynecol 20081-47(1):57-61]Öğe Cotyledonoid dissecting leiomyoma of the uterus with intravascular growth in postmenopausal woman: a case presentation(SPRINGER JAPAN KK, 2011) Gezginc, Kazim; Yazici, Fatma; Selimoglu, Refika; Tavli, LemaCotyledonoid dissecting leiomyoma ("Sternberg tumor") is an unusual type of a benign uterine smooth-muscle tumor with a distinctive gross appearance. A 57-year-old woman (gravida 7, para 6), in menopause for 3 years, presented with a 3-4-year history of increased pelvic pain. The transvaginal ultrasound scan showed a 2.5 cm sized heterogenic mass in the uterus cavity and 4 x 5 cm sized irregular contoured mass in the right lateral aspect of the uterus. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed with removal of the pelvic tumor extension. Definite pathologic examination result was cotyledonoid dissecting leiomyoma of the uterus with intravascular growth. The patient is receiving follow-up care every 6 months, and she has no evidence of disease after 22 months of follow-up. The worrying appearance of the gross specimen is often mistaken for malignant or non-uterine lesions that may result in overtreatment. It is important to be aware of this entity to prevent overly aggressive treatment for this benign smooth-muscle neoplasm.Öğe Course of panic disorder during the early postpartum period: a prospective analysis(W B SAUNDERS CO-ELSEVIER INC, 2008) Guler, Ozkan; Koken, Gulengul N.; Emul, Murat; Ozbulut, Omer; Gecici, Omer; Uguz, Faruk; Gezginc, KazimPurpose: Most of the studies about course of panic disorder (PD) after childbirth have a retrospective nature. The aim of the current study was to examine prospectively the clinical course of 13 pregnant women with a diagnosis of PD across pregnancy and the early postpartum period. Method: The diagnosis of PD was determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders in the third trimester of pregnancy. Within the same period, the Panic and Agoraphobia Scale was used to determine the severity of PD. The last assessment with both instruments was performed at 6 weeks postnatally. Results: Of these 13 women, 6 (group 1) reported that PD developed during the 6th to the 28th week of their gestation, and the number of women who experienced PD symptoms before pregnancy (group 2) was 7. It was found that the severity of panic symptoms considerably decreased in the total sample, group 1, and group 2 from the basal levels to 6 weeks postnatally. Conclusion: Our study results suggest that pregnant women with PD may experience a marked improvement in PD symptoms in the early postpartum period. (c) 2008 Elsevier Inc. All rights reserved.Öğe Effects of menopause on the myocardial velocities and myocardial performance index(JAPANESE CIRCULATION SOC, 2007) Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Sokmen, Abdullah; Soylu, Ahmet; Aygul, Nazif; Gezginc, Kazim; Tokac, MehmetBackground Although menopause is known to increase cardiovascular risk and mortality, the effect of menopause on cardiac functions has not been investigated in detail. This study investigates the effect of menopause on cardiac functions by tissue Doppler echocardiography (TDE) and myocardial performance index (MPI). Methods and Results A total of 72 postmenopausal and 71 age-matched premenopausal women were enrolled in the study. After conventional echocardiographic parameters were measured, TDE recordings were obtained at the septal, lateral, anterior and inferior side of the mitral annulus, and tricuspid lateral annulus. Systolic velocity (Sm), early and late diastolic velocities (Em and Am) and time intervals were measured and MPI was calculated. A sequentially symptom-limited exercise stress test was performed. Although left ventricular (LV) ejection fraction and end-diastolic and end-systolic diameter were similar in both groups, LV septum and posterior wall thickness were higher in postmenopausal women. Mitral early inflow velocity and mitral early inflow velocity:mitral late inflow velocity ratio were significantly lower in postmenopausal women compared to premenopausal women. LV Sm, and LV and right ventricular (RV) Em:Am ratios were lower in postmenopausal women. MPI calculated by TDE was significantly increased in postmenopausal women. In addition, exercise duration and metabolic equivalent values were significantly lower in postmenopausal women than in premenopausal women. Conclusions Menopause negatively affects MPI and myocardial velocities, both of which provide more quantitative data about myocardial functions. These findings indicate that the hormonal changes in menopause impair LV systolic and diastolic functions and RV diastolic function.Öğe The impact of obsessive-compulsive disorder in pregnancy on quality of life(TAYLOR & FRANCIS LTD, 2008) Gezginc, Kazim; Uguz, Faruk; Karatayli, Savas; Zeytinci, Esra; Askin, Ruestem; Gueler, Oezkan; Sahin, FigenAim. To examine the effects of obsessive-compulsive disorder (OCD) on quality of life in pregnant women. Material and method. Twenty-five pregnant women diagnosed as OCD in two university outpatient clinics were included for the study. Twenty-five pregnant women with no mental disorders and the same sociodemographic properties were taken as the control group. The diagnosis of OCD was confirmed with the DSM-IV Axis-I Disorders Structured Clinic Interview Diagnosis/Clinic Version (SCID-I/CV). In order to measure the severity of OCD Yale-Brown Obsession and Compulsion Scale was performed. Quality of life was evaluated by WHO (World Health Organisation) Life Quality Scale - Short Form (WHOQOL-Brief). Results. The whole subgroup of points of WHOQOL-Brief was significantly lower in OCD patients compared to control group (in all subgroups P < 0.01). There was a negative correlation between the Y-BOCS obsession and compulsion subpoints and total points with the physical health (P < 0.05), psychological health (P < 0.001) and social relationship (P < 0.01) of WHOQOL-Brief. No significant association was found with enviromental areas. Besides, there was a negative correlation between the duration of OCD and WHOQOL-Brief psychological health subarea (P < 0.05). Conclusion. OCD negatively effects the quality of life in pregnant women and is correlated with the severity of the disorder.Öğe Management and outcomes of adnexal masses during pregnancy: A 6-year experience(WILEY-BLACKWELL, 2008) Balci, Osman; Gezginc, Kazim; Karatayli, Rengin; Acar, Ali; Celik, Cetin; Colakoglu, Mehmet C.Aim: To demonstrate adnexal masses detected during gestations in a 6-year period. Methods: A retrospective study of pregnancy with adnexal masses requiring surgery over a 6-year period at the Selcuk University Hospital, a tertiary referral center, between June 2000 and June 2006. Results: We detected 36 pregnancies with adnexal masses. The mean age of the patients was 26.6 years (range, 18-42). The mean gestational age at which adnexal masses were detected was 17 weeks (range, 5-36), and the mean gestational age at the time of surgery was 24 weeks (range, 6-41). Postoperative pathology results of the patients were functional ovarian cysts in 14 cases (41.1%), endometrioma in eight cases (23.5%), dermoid cyst in six cases (17.6%), serous cystadenoma in two cases (5.8%), mucinous cystadenoma in one case (2.9%), para-ovarian cyst in one case (2.9%), and borderline serous tumor in two cases (5.8%). Two patients operated on during the second trimester developed preterm birth risk (5.8%). Miscarriage occurred in only one patient (2.9%). Conclusion: In this report, we demonstrate a high rate of surgical intervention of adnexal masses at pregnancy which is secondary to the fact that our center works as a tertiary referral center. Most masses at pregnancies were benign in character and our malignity rate was low. We detected an acceptable complication rate due to surgery in pregnant women.Öğe A New Technique For the Treatment of Transverse Vaginal Septum by Foley Catheter(ELSEVIER SCIENCE INC, 2011) Gezginc, Kazim; Yazici, Fatma; Karatayli, Rengin; Acar, AliWe report a new surgical technique for the management of transverse vaginal septum in a 13-year-old girl who presented with abdominal pain. Imaging techniques yielded hematocolpos. The patient and her family refused vaginal surgery in order to preserve hymenal integrity for sociocultural beliefs. At laparotomy, a vertical incision was made on posterior vaginal wall. An artery forceps was introduced from the hymenal opening while preserving the hymenal integrity. The septum located on the upper third of vagina was perforated by the help of a forceps introduced from posterior vaginal wall via an abdominal route. A Foley catheter was introduced from the introitus toward the septal perforation and was held by the forceps. The balloon of the catheter was placed on the perforated septum and it was insufflated with 10 ml of fluid. The Foley catheter was in place for 2 weeks. After removal of the catheter, she received oral contraceptive pills for 3 months postoperatively. She had regular spontaneous menses on follow-up for 6 months duration.Öğe NONCARDIOGENIC PULMONARY EDEMA DUE TO RITODRINE USAGE IN PRETERM LABOR(ELSEVIER SINGAPORE PTE LTD, 2008) Gezginc, Kazim; Guel, Mehmet; Karatayli, Rengin; Cander, Baser; Kanat, Fikret[Abstract not Available]Öğe Ovarian cancer during pregnancy(ELSEVIER IRELAND LTD, 2011) Gezginc, Kazim; Karatayli, Rengin; Yazici, Fatma; Acar, Ali; Celik, Cetin; Capar, MetinObjective: To evaluate the clinical features, pregnancy outcome, and treatment of patients with ovarian cancer diagnosed during pregnancy. Methods: The present study was a retrospective review of 11 cases of ovarian cancer detected during pregnancy. The women were treated and followed up at Selcuk University, Meram Faculty of Medicine, Konya, Turkey, during 2006-2010. Results: Approximately half the patients were asymptomatic (5 [45.5%]) and diagnosed during cesarean delivery (6 [54.5%]). The histopathologic tumor categories comprised malignant epithelial ovarian tumor (4 [36.4%]), borderline tumor (4 [36.4%]), malignant germ cell tumor (2 [18.2%]), and sex cord stromal tumor (1 [9.1%]). Nine (81.8%) tumors were classified as stage I. Conservative surgery was performed in 10 (90.9%) patients. A patient with stage IIIC serous papillary adenocarcinoma underwent hysterectomy with bilateral salpingo-oophorectomy. A patient with dysgerminoma in stage IV died on follow-up. Three infants were born premature; they were followed up in the neonatal intensive care unit with satisfactory outcomes. Conclusion: Early diagnosis and appropriate treatment are crucial for patients with ovarian cancer diagnosed during pregnancy. Tumor staging is possible during pregnancy, but the appropriateness of surgery needs to be considered carefully. Ideally, the treatment strategy should be discussed and structured on an individual basis. (C) 2011 Intemational Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Pregnancy-Onset Panic Disorder: Incidence, Comorbidity and Associated Factors(AVES, 2015) Guler, Ozkan; Kaya, Veli; Gezginc, Kazim; Kayhan, Fatih; Cicek, Erdin; Sonmez, Onder; Uguz, FarukIntroduction: The present study aimed to investigate the incidence rate of pregnancy-onset panic disorder (POPD) among Turkish pregnant women using a diagnostic interview. Additionally, we examined whether the independent socio-demographic or clinical risk factors were associated with the risk of panic disorder in these women. Methods: The study sample comprised 1475 consecutive pregnant women who presented to the obstetric outpatient clinics of two research centers. The rate of POPD in these participants was 1.3% (Group 1, n= 20). The 20 women with POPD were compared with 250 pregnant women without pregnancy-onset depression or anxiety (Group 2; controls). Panic disorder and other anxiety or mood disorders were determined by means of the Structured Clinical Interview for DSM-IV. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders. Results: The incidence rate of panic disorder was 1.3% (n= 20). In group 1, 55% (n= 11) of the women with POPD had an additional mood or anxiety disorder. In addition, the prevalence rate of any cluster C personality disorder, including avoidant, passive-aggressive and obsessivecompulsive personality disorders, were significantly greater in the group 1 women with POPD than the control pregnant women without a panic disorder (group 2). Conclusion: The women with POPD were more likely than the controls to have a cluster C Axis II disorder and a history of a pre-existing anxiety or mood disorder.Öğe Prenatal diagnosis of Milroy's primary congenital lymphedema(ELSEVIER TAIWAN, 2012) Gezginc, Kazim; Yazici, Fatma; Gok, Dilay[Abstract not Available]Öğe Prevalence and Related Factors of Mood and Anxiety Disorders in a Clinical Sample of Postmenopausal Women(WILEY-BLACKWELL, 2011) Sahingoz, Mine; Uguz, Faruk; Gezginc, KazimPURPOSE: The purpose of the study was to investigate the prevalence and related factors of mood and anxiety disorders in postmenopausal women attending a gynecological outpatient clinic. METHODS: The study sample included 269 postmenopausal women. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition was performed to determine the disorders. RESULTS: Ninety-two (34.2%) women had at least one mood or anxiety disorder. The most common specific disorder was generalized anxiety disorder (15.6%). The existence of any mood or anxiety disorder was associated with poorer economic level. CONCLUSIONS: Mood and anxiety disorders were frequently observed in postmenopausal women who were admitted to a gynecology outpatient clinic.Öğe The prevalence of panic disorder in pregnant women during the third trimester of pregnancy(W B SAUNDERS CO-ELSEVIER INC, 2008) Guler, Ozkan; Sahin, Figen Kir; Emul, H. Murat; Ozbuut, Omer; Gecici, Omer; Uguz, Faruk; Gezginc, KazimObjective: The principal aim of this study was to assess the current prevalence rate of panic disorder (PD) in pregnant women during the third trimester of pregnancy. The second aim of the present study was to investigate the clinical characteristics of PD in pregnant and nonpregnant women. Method: The study data were gathered from 512 consecutive women in the third trimester of pregnancy who were admitted to the obstetric outpatient clinics of 2 university research centers. The diagnosis of PD was determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I disorders in the third trimester of pregnancy. Within the same period, the Panic and Agoraphobia Scale was used to determine the severity of PD. In addition, we compared the clinical characteristics of PD in gravid subjects (n = 13) with their control group. A control group was composed of 19 consecutive nonpregnant female outpatients diagnosed with PD who presented to the psychiatric outpatient clinics of the same hospitals. Results: The prevalence rate of PD was found to be 2.5% (n = 13) among the subjects in the third trimester of pregnancy. Of these 13 pregnant, 7 subjects reported that PD developed during the 6th to 28th weeks of their gestation, and the number of subjects who experienced PD symptoms before pregnancy was 6. In addition, there was no statistically difference between gravid and nongravid PD cases with regard to the severity of panic symptoms. Conclusion: Our study suggests that PD may be common among pregnant females during the third trimester of pregnancy and seems to be associated with similar clinical features during gestation and nongestation. (c) 2008 Elsevier Inc. All rights reserved.Öğe QUALITY OF LIFE IN POSTMENOPAUSAL WOMEN: THE IMPACT OF DEPRESSIVE AND ANXIETY DISORDERS(SAGE PUBLICATIONS INC, 2011) Uguz, Faruk; Sahingoz, Mine; Gezginc, Kazim; Ayhan, Medine GiynasObjective: Psychiatric symptoms are frequently present in postmenopausal women. The present study aimed to investigate the impact of depressive and anxiety disorders on the quality of life (QoL) of postmenopausal women. Method: The study sample consisted of 342 postmenopausal women who presented to the Gynecology Outpatient Clinic. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition was used to determine depressive and anxiety disorders. The participants' QoL level was assessed by means of the World Health Organization QoL Assessment-Brief (WHOQOL-BREF). Results: Subjects without a diagnosis of depressive or anxiety disorder had significantly higher points in all domains of WHOQOL-BREF. According to linear regression analysis, all evaluated disorders except social phobia and specific phobia were independently associated with lower scores for at least one dimension of the QoL scale. However, major depression, dysthymic disorder, and generalized anxiety disorder predicted all domains of WHOQOL-BREF. Conclusion: Depressive and anxiety disorders, particularly major depression, dysthymic disorder, and generalized anxiety disorder, seem to be considerable factors affecting the QoL in postmenopausal women. (Int'l. J. Psychiatry in Medicine 2011;41:281-292)Öğe Results of hysterosalpingogram in women with previous B-Lynch suture(WILEY, 2011) Gezginc, Kazim; Yazici, Fatma; Koyuncu, Tuba[Abstract not Available]Öğe Successful treatment of uterine prolapse by abdominal hysteropexy performed during cesarean section(SPRINGER HEIDELBERG, 2013) Karatayli, Rengin; Gezginc, Kazim; Kantarci, Ali Haydar; Acar, AliUterine prolapse complicating pregnancy is extremely rare. This report presents the surgical correction of uterine prolapse during cesarean section. We report a case of a 33-year-old woman with twin gestation who admitted to obstetric clinic with labor pain and total uterine prolapse at 33 weeks of gestation. An emergent cesarean section was performed for the indication of acute fetal distress. At the same operation, following cesarean delivery, abdominal hysteropexy using rectus fascia strips was performed successfully. On control performed 6 months later, patient was examined and it was detected uterine prolapse had regressed and babies were uneventful. This surgical method offers effective treatment of uterine prolapse.Öğe Uterine smooth muscle tumors of uncertain malignant potential: a case presentation(SPRINGER TOKYO, 2011) Gezginc, Kazim; Yazici, Fatma; Tavli, LemaA 42-year-old virgin woman was admitted to our clinic with increasing menorrhagia and dysmenorrhea for several months. A pelvic ultrasound scan showed a 9 x 7 cm heterogeneous mass in the uterine cavity. Pelvic magnetic resonance imaging showed a large non-homogeneous tumor mass measuring 97 x 56 mm in the uterine cavity. After intravenous contrast material, cystic necrotic areas with marked contrast enhancement were observed in the solid lesion. Tumor markers were all within normal ranges. The patient underwent laparotomy, and total hysterectomy and bilateral salpingo-oophorectomy were performed. Our case was diagnosed as uterine smooth muscle tumor of uncertain malignant potential (STUMP). The patient was put on a close clinical follow-up schedule, and is doing well without recurrence in 2 years later. Patients with STUMP should be counseled regarding the potential for recurrence as leiomyosarcoma, and may require closer surveillance than a yearly examination and may need a consultation with a gynecologic oncologist.
